U.S. flag

An official website of the United States government

Dot gov

The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Department of Health and Human Services

Office of Inspector General -- AUDIT

"Post Retirement Benefit Costs Claimed by Horizon Blue Cross Blue Shield of New Jersey," (A-07-03-03044)

August 6, 2004


Complete Text of Report is available in PDF format (130 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

The objective of  this review was to determine the allowability of $2,652,795 in Post Retirement Benefit (PRB) costs claimed for Medicare reimbursement by Horizon Blue Cross Blue Shield of New Jersey (Horizon).   The $2,652,795 represents PRB costs that will be incurred subsequent to the termination of Horizonís Medicare contract.  We found that Horizonís claim for $2,652,795 of PRB costs is unallowable for Medicare reimbursement.  We recommended that Horizon withdraw its claim for the $2,652,795 of unallowable PRB costs.  Horizon did not comment on our finding and recommendation.